As more than 300 million people globally now live in jurisdictions where assisted dying is legal, the landscape of end-of-life care continues to evolve. Since UK MPs last debated the issue in 2015, nations including Canada, Australia, New Zealand, Spain, and Austria have enacted their own legislation, with some extending access to individuals who are not terminally ill.
In the United States, assisted dying is permitted in 30 states and Washington DC. Oregon stands as a pioneer, having introduced its model law in 1997 for terminally ill, mentally competent adults with a life expectancy of six months or less. Over the past two decades, 5,520 individuals have received lethal prescriptions there, resulting in 3,691 deaths. According to a 2025 report, cancer was the primary diagnosis for 61% of applicants, followed by neurological conditions at 14% and heart disease at 11%. The most frequently cited reasons for seeking assistance included loss of autonomy (89%), loss of dignity (65%), and fear of losing bodily control (47%). Approximately one-third of those prescribed the medication choose not to take it.
Canada, often referenced by opponents as an example of a “slippery slope,” legalized Medical Assistance in Dying (MAID) in 2016 for the terminally ill. By 2021, the scope expanded to include those enduring unbearable suffering from irreversible illnesses or disabilities, though plans to include mental illness have been paused. The number of MAID procedures has risen sharply, with roughly one in twenty deaths in Canada now medically assisted, compared to one in one hundred in Oregon.
European laws vary significantly. Switzerland legalized assisted suicide in 1942 and permits foreigners to access services through organizations such as Dignitas in Zurich; over 500 British citizens have utilized these services. The Netherlands and Belgium, which legalized the practice over 20 years ago for incurable suffering, are the only European nations permitting euthanasia for children. Spain and Austria recently legalized assisted dying for both terminal illness and intolerable suffering. While Austria requires self-administration, Spain allows medical professionals to administer the lethal dose.
Within the British Isles, Jersey received Royal Assent for its bill in July, with the first cases potentially occurring late next year. Notably, Jersey allows for intravenous administration by a doctor, differing from the self-administration mandates proposed at Westminster, Holyrood, and the Isle of Man. The Isle of Man passed its bill in March 2023, but after an initial refusal of Royal Assent, an updated bill has been resubmitted. If approved, the service could launch next year with a five-year residency requirement.
Across Australia and New Zealand, voluntary assisted dying is now legal in most regions, with the Northern Territory being the latest to pass legislation. While New Zealand restricts eligibility to those with a life expectancy of six months, Australian laws generally extend this to 12 months for neurodegenerative conditions. Patients in both countries may self-administer medication or receive it via injection from a medical professional.
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